Patient-centred care and cultural safety

Adam La Caze

Learning outcomes

  1. Identify and make judgments about patient-centred care
  2. Be able to describe and defend what it means for pharmacists to be culturally competent/culturally safe

Engagement tasks

  1. Patient-centred care task: Annie, Leanne, Aaron

Patient-centred care

What is patient-centred care?

Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions (Institute of Medicine, 2001)

Havi Carel, Illness

Empathy. If I had to pick the human emotion in greatest shortage, it would be empathy. And this is nowhere more evident in illness. The pain, disability and fear are exacerbated by the apathy and disgust with which you are sometimes confronted when you are ill.

Royal Commission into Aged Care Quality and Safety, Interim Report (2019):

We have uncovered an aged care system that is characterised by an absence of innovation and by rigid conformity. The system lacks transparency in communication, reporting and accountability. It is not built around the people it is supposed to help and support, but around funding mechanisms, processes and procedures. This, too, must change.

Patient-centred labels

Patient-centred care engagement task

Cultural safety

Race, racism and discrimination

What is race? (What kind of thing is race?)

What is racism? (Is there a difference between racism and discrimination?)

Discrimination

Cultural competence continuum

Ahpra Shared code of conduct

Ahpra Shared Code of Conduct, 2.2.

Cultural safety is determined by Aboriginal and Torres Strait Islander individuals, families and communities.

Culturally safe practice is the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practising behaviours and power differentials in delivering safe, accessible and responsive healthcare free of racism.

To ensure culturally safe and respectful practice, you must:

  1. acknowledge colonisation and systemic racism, social, cultural, behavioural and economic factors which impact individual and community health
  2. acknowledge and address individual racism, your own biases, assumptions, stereotypes and prejudices and provide care that is holistic, free of bias and racism
  3. recognise the importance of self-determined decision-making, partnership and collaboration in healthcare which is driven by the individual, family and community
  4. foster a safe working environment through leadership to support the rights and dignity of Aboriginal and Torres Strait Islander people and colleagues.

Belton, S., Kruske, S., Jackson Pulver, L., Sherwood, J., Tune, K., Carapetis, J., Vaughan, G., Peek, M., McLintock, C., & Sullivan, E. (2018). Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58(4), 425–431. https://doi.org/10.1111/ajo.12744

References

Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US).